CANDIDATE: Dr. DeVoe is proposing to study how loss of parental health insurance affects children's access to health care services. She will continue to build upon her solid health services research foundation by working with expert mentors who support her goal of becoming an independent investigator. RESEARCH FOCUS: Despite programs such as Medicaid and the State Children's Health Insurance Program (SCHIP), many children in the U.S. do not currently have health insurance. It has been shown that expanding parental coverage leads to improved access to health insurance for children. LESS IS KNOWN ABOUT HOW TERMINATION OF PARENTAL COVERAGE AFFECTS CHILDREN. The Oregon Health Plan (OHP), an innovative Medicaid expansion program, has recently implemented cost sharing measures that have led to the loss of coverage for thousands of Oregon parents. Although these OHP policies were aimed at adults, there may be an indirect affect on children. This proposal expands on current research and has been designed to focus on how parental insurance loss is affecting children's access to care. TRAINING GOALS: Dr. DeVoe's training goals include: (1) broadening her knowledge and experience in large database management and advanced statistical analysis, with a focus on identifying variables to link across state and national datasets and the use of propensity scores and longitudinal analytical techniques; and (2) expanding her skills in conducting policy relevant studies and disseminating findings more effectively, with formal training in the use of geographic information system (CIS) software. METHODS: (1) Cross-sectional analysis and GIS spatial analysis of the national Medical Expenditure Panel Survey and a survey of Oregon parents. (2) Longitudinal analysis of three waves of survey data from an ongoing statewide prospective cohort study. OUTCOMES: We will measure how parental loss of insurance and other barriers to children's insurance coverage are associated with differences in children's health insurance enrollment rates, access to health care services, patterns of health services utilization, and reported health status. RELEVANCE: This analysis will provide valuable information for states attempting to expand children's health insurance coverage and looking for ways to minimize barriers in order to keep children insured.